How Does Holiday Stress, Anxiety, and Depression Affect Those with SUD?  

While the holiday season is a source of joy for many, for many others it can bring on feelings of stress, anxiety, and depression. 

According to a survey by the American Psychological Association, 38 percent of people said their stress and anxiety level increases during the holidays. And nearly a quarter reported feeling “extreme stress.”[1

These difficult feelings can cause problems for anyone, but they’re particularly dangerous for those with substance use disorder (SUD)—especially those who aren’t aware of the risks and their personal vulnerabilities. 

What makes the holidays a breeding ground for challenging feelings? How does holiday stress increase a person’s risk of return to use? What steps can a person in recovery take to mitigate the risk of return to use during the holiday season? 

Why Are Stress, Anxiety, and Depression So Common During the Holidays? 

There are several reasons why a person with SUD (or anyone for that matter) may experience stress, anxiety, or depression over the holidays. While not an exhaustive list, here are the top factors:  

  • Social isolation: Some people have a small social circle or a lack of opportunities for socialization. These individuals are at a greater risk of feeling lonely, and loneliness is a known risk factor for increased substance use.[2]
  • Family gatherings: On the flip side, family gatherings can be stressful for many reasons, such as preparation, playing host, being around toxic relatives, reliving unpleasant memories, and being asked invasive questions.
  • Schedule disruptions: The holiday season brings up many disruptions to normal schedules. For example, a person might have deadlines to meet before the holiday break or more free time than usual. Therapists or sponsors may also go out of town, leaving a person without a reliable person to turn to for support. 
  • Increased time demands: It’s common for people to experience increased demands from their spouses, partners, or other family members during the holiday season. Combined with difficulty setting boundaries, these demands can cause serious stress. 
  • Alcohol prevalence: During the holiday season, alcohol and other substances are more commonplace at social gatherings and parties. Additionally, attending holiday events can mean reconnecting with former drinking or drug-using acquaintances. These factors can cause anxiety and stir up temptation for those with SUD. 
  • Financial concerns: Crowded stores, holiday gift lists, and more money spent than usual all take a toll on a person’s ability to manage stress during this time of year. 
  • Seasonal Affective Disorder (SAD): Also known as the “winter blues,” SAD is a subtype of depression that typically begins in the fall and continues into the winter months.[3
  • Grief: If a person has lost a loved one or gone through a recent breakup, the holidays can amplify the feeling of loss, spurring feelings of sadness, grief, anxiety, and depression. 

How Does Holiday Stress Increase a Person’s Risk of Return to Use? 

Triggers come in many forms, but stress is one of the biggest. In one study of individuals with SUD, exposure to personal stressors led to significant drug cravings.[4]

For those in recovery from SUD, the results are similar. One study found that people who were newly abstinent following cocaine abuse had increased sensitivity to emotional distress than controls and also experienced greater drug cravings due to stress cues.[5]

Another study found that people with alcohol use disorder who had been sober for four weeks reported far greater levels of distress and alcohol cravings in response to stress than social drinkers.[6]

While the exact role of stress and return to use is unclear, one reason for this correlation may have to do with changes in the brain and brain activity as a result of dependency. With time, drug and alcohol use can modify the brain’s stress and dopamine pathways, inhibiting their normal functioning and leading to heightened drug cravings, especially when stress levels are high.[7]

Tips for Combatting Holiday Stress, Anxiety, and Depression 

In previous blogs, we’ve shared tips for maintaining sobriety over the holidays, as well as how healthcare providers, employers, and friends can support those in SUD recovery during this time of year. 

In this article, we’ll be focusing more specifically on how to combat holiday stress, anxiety, and depression. Here are our top tips: 

#1: Avoid the Happiness Trap

There are many expectations during the holidays—for feeling joyful, having meaningful get-togethers, buying people the perfect gifts, decorating, preparing holiday meals, and so much more. 

These expectations can set you up for the “happiness trap.” Trying too hard to be happy or make things go a certain way can backfire and make you feel stressed and unhappy, especially if your experiences don’t live up to your expectations. 

Do your best to embrace the holiday season, however it looks for you, and avoid comparing your experience to that of others. And remember, many people experience stress and anxiety during the holidays. What you see on holiday cards and social media is often not people’s reality.

#2: Plan Ahead of Your Stressors 

A key way to cope with holiday stress is to anticipate your potential stressors. To determine your unique stressors, it can help to think back to prior holidays and note which moments were the hardest. Pick your top three predicted stressors and have one or two action steps to help mitigate those stressors. 

For example, if you feel triggered by family members asking questions that make you feel unsuccessful—“When are you getting married?” or “How’s your career going?”— plan a response that you can deliver or a way to remove yourself from the conversation. 

#3: Focus on What Makes You Happy 

Our brains are wired to focus more on what’s going wrong in our lives than what’s going right. To combat this, consider what makes you happy during the holiday season and try your best to maximize those moments, whether it’s baking cookies or spending time with your favorite relative. 

#4: Up Your Self-Care 

When the holidays are in full swing, it can be easy to put self-care on the back burner. But for many people, the holiday season is a time when you need to ramp up your self-care rather than scale it back. 

Focus on making time for healthy habits like getting enough sleep, eating well, exercising, journaling, and relaxing. 

#5: Reach Out for Help 

If you notice your stress, anxiety, and depression are escalating or you feel like you could benefit from some support, don’t hesitate to reach out. Here are some options:

  • Confide in a friend, family member, sponsor, or therapist
  • Attend an in-person recovery meeting
  • Call SAMHSA’s Helpline, 1-800-662-HELP (4357)—a confidential, free line for individuals and family members facing mental and/or substance use disorders. You can talk to someone in English or Spanish 24-hours-a-day, 365-days-a-year.

Having people you feel safe going to for support is essential in recovery. That’s why CHESS Health created the Connections app and the Spanish language version, Conexiones. 

These evidence-based smartphone apps are staffed by certified peer recovery specialists who have lived experience with SUD. They offer 24/7 support and moderate lively discussion groups and video support meetings. 

Note: Connections and Conexiones are only available through a behavioral health provider.

Connect with CHESS Health 

CHESS Health collaborates with health plans, state and local governments, other public sector organizations, and clinicians to provide evidence-based programs that support the addiction management and recovery lifecycle. 

It’s our goal to help providers support SUD patients in achieving higher abstinence rates, reduced recurrence of use, and lower care costs.

To learn more about our technology, get in touch with CHESS Health today